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BACKGROUND: The exact prevalence and incidence of rosacea remain unknown, although it is a common condition associated with severe noncutaneous diseases. OBJECTIVES: To perform a systematic review of the published literature to examine the global incidence and prevalence of rosacea. METHODS: A systematic review of population-based and dermatological outpatient studies reporting the incidence and/or prevalence of rosacea was performed using three electronic medical databases: PubMed, Embase and Web of Science. Data were extracted and a proportion meta-analysis was performed to obtain pooled proportions. RESULTS: In total 32 studies were included examining a total of 41 populations with 26 519 836 individuals. Twenty-two populations were from Europe, three from Africa, four from Asia, nine from North America and three from South America. The pooled proportion of individuals with rosacea was 5·46% [95% confidence interval (CI) 4·91-6·04] in the general population and 2·39% (95% CI 1·56-3·39) among dermatological outpatients. Self-reported rosacea gave higher prevalence estimates than rosacea diagnosed by clinical examination, suggesting a low specificity of questionnaires based on symptoms. Rosacea affected both women (5·41%, 95% CI 3·85-7·23) and men (3·90%, 95% CI 3·04-4·87), and mostly those aged 45-60 years. CONCLUSIONS: We estimated the global prevalence of rosacea based on published data and found that 5·46% of the adult population is affected. However, the prevalence of rosacea depended on the diagnostic method, with higher estimates in questionnaire studies of rosacea symptoms and lower estimates in health registries with International Classification of Diseases codes.

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BACKGROUND: Parabens may be added to cosmetic and personal care products for preservation purposes. Low-molecular weight (LMW) phthalate diesters function as plasticizers, fixatives or solvents in such products, but may also be found in small quantities as contaminants from plastic containers. OBJECTIVE: To evaluate the association between emollient use, atopic dermatitis and FLG mutations, respectively, with urinary concentrations of phthalate metabolites and parabens in Danish children. METHODS: Eight hundred and forty-five Danish children 4-9 years of age were studied. Urinary concentrations of phthalate metabolites and parabens were determined, and children were genotyped for common FLG loss-of-function mutations. Information about atopic dermatitis and use of emollients was obtained from questionnaires completed by parents. RESULTS: The prevalence of atopic dermatitis was 16.1%. Phthalate metabolite and paraben levels were generally higher in children with frequent use of emollients compared to uncommon users, reaching statistical significance for some LMW phthalates and parabens. While there was no association with common FLG mutations, children with atopic dermatitis had significantly higher urinary levels of one LMW phthalate and two parabens, respectively, when compared to children without atopic dermatitis. CONCLUSION: Emollient use and atopic dermatitis were associated with modestly increased internal LMW phthalate and paraben exposure in 4-9 year old children. It is unknown whether the difference is explained by increased use of the specific emollients that are used to treat pruritic and inflamed skin, and/or whether the impaired skin barrier allows chemicals to penetrate more easily. Moreover, the putative toxicological burden is unknown.

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Little is known about the tissue reactions to various implant materials which coincide with an inflammatory reaction. We used the avridine arthritis rat model to evaluate the tissue response in the synovial, interstitial and subcutaneous tissues after implant insertion. Quantitative immunohistochemistry showed that normal joint synovial tissue is dominated by ED2-positive resident macrophages. Polyethylene implants induced a much stronger foreign-body reaction than titanium implants, as measured by the number of interfacial ED1-positive macrophages. The tissue response to titanium and polyethylene was also vastly different in arthritic synovial tissue compared with control tissue. It is likely that these biomaterials interact differently with inflammatory cells or intermediary compounds. It may be that arthritic synovial tissue produces reactive oxygen intermediates (free radicals) with which titanium has a unique anti-inflammatory interaction in vitro.

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UNLABELLED: Endocervical sampling for microbiological and pathological screening is laborious and expensive due to different sampling devices and techniques. The purpose of this study was to examine if the routine procedure could be simplified by using a cytobrush for concurrent cytology and sampling for Chlamydia trachomatis detection using the PCR method or cell culture. As a sampling device control we used a conventional rayon swab. RESULTS: Culture: Out of 873 paired endocervical specimens, C. trachomatis was isolated in 68 swab specimens and in 65 cytobrush specimens (overall detection rate 8.4%). The cytobrush proved less suitable than the swab for the isolation of C. trachomatis as 31.5% of the cytobrush samples showed cytotoxicity to the cultured cells vs 0.9% of the swab samples. PCR: In a random sample of 427 paired endocervical specimens, C. trachomatis was detected in 45 pairs without any difference between the two sampling devices. The sensitivity of PCR was 93.8% vs 89.6% and 87.5% in cultured swab and cultured cytobrush specimens, respectively. The cytobrush can therefore be recommended as a cervical sampling device if a PCR assay is used for the detection of C. trachomatis, but not if the cell culture method is used, due to high cytotoxicity. Furthermore, the same cytobrush may be used for cervical cytological sampling and thereafter placed in transport medium for subsequent C. trachomatis detection if the PCR technique is used.

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Two types of portable reflectance instruments, tristimulus colorimeters (Chroma Meter CR-200) and narrow-band spectrophotometers (Dermaspectrometer), have recently become available for the quantification of skin color. In order to know the difference and the relationship between the different color systems, the CIE L*a*b* system and the erythema melanin (E/M) indices, respectively, adopted by the two, the variations in skin color were measured at 23 different anatomical sites of 10 healthy Caucasian male subjects. The reddish tint of the skin color of the face, palm and sole was readily detected by either of them in the increase in the a* value or in the E index, and a strong linear correlation (r = 0.92, p < 0.001) was noted between the two values. The fair color appearance of the trunk was detected in the high L* value and in the low M index, but the correlation between the two was much less significant (r = -0.56, p < 0.001). Although the mean b* values were highest in the trunk, they are significantly lower on the non-light-exposed side than those on the light-exposed side of the arm. The correlation between the b* value and the M index was weak.

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